超早期应用阿替普酶静脉溶栓对脑梗死患者临床转归的影响
李鸿飞 徐冬娟 张为强 郭翔
浙江省东阳市人民医院神经内科,浙江东阳 322100
Effect of Alteplase on ultra early stage for clinical outcome of patients with cerebral infarction
LI Hongfei XU Dongjuan ZHANG Weiqiang GUO Xiang
Department of Neurology, Dongyang People's Hospital, Zhejiang Province, Dongyang 322100, China
摘要 目的 探讨超早期应用阿替普酶静脉溶栓对脑梗死患者临床转归的影响。 方法 选取2015年10月~2016年12月东阳市人民医院收治的120例脑梗死患者,采用随机数字表分为观察组(60例)和对照组(60例),对照组给予常规治疗,观察组在对照组的基础上超早期应用阿替普酶静脉溶栓,两组均治疗14 d。比较两组治疗后的神经特异性烯醇化酶(NSE)、中枢神经特异性蛋白(S100β)、炎症因子水平、神经功能、生活能力以及不良反应。 结果 观察组治疗后的NSE、S100β低于对照组,白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)低于对照组,差异有统计学意义(P < 0.05)。观察组治疗后的MBI评分高于对照组,NIHSS评分低于对照组,差异有统计学意义(P < 0.05)。两组治疗后的不良反应差异无统计学意义(P > 0.05)。 结论 超早期应用阿替普酶溶栓能够显著降低脑梗死患者的炎症因子、NSE、S100β的水平,改善神经功能和生活能力,且不良反应少,是一种安全有效的治疗方法。
关键词 :
超早期 ,
阿替普酶 ,
静脉溶栓 ,
NSE ,
神经功能
Abstract :Objective To investigate the effect of Alteplase on ultra early stage for clinical outcome of patients with cerebral infarction. Methods From October 2015 to December 2016, in Dongyang People's Hospital, 120 cerebral infarction patients were selected, they were divided into the observation group (60 cases) and control group (60 cases) by random number table, the control group was given routine treatment, the observation group was given Alteplase on ultra early stage based on the control group, two groups were treated for 14 d. Neuron specific enolase (NSE), central nerve specific protein (S100β) and inflammatory factor, neurological function, life ability and adverse reaction of two groups were compared. Results After treatment, the NSE and S100 in observation group were lower than those in control group, IL-6, TNF-a, CRP was lower than those in control group, the differences were statistically significant (P < 0.05). The MBI score in observation group was higher than that in control group, the NIHSS score was lower than that in control group, the differences were statistically significant (P < 0.05). There was no significant difference in adverse reactions between the two groups (P > 0.05). Conclusion Alteplase on ultra early stage can significantly reduce inflammatory factors, NSE and S100β level of patients with cerebral infarction, improve neurological function and life ability, and less adverse reactions, it is a safe and effective treatment method.
Key words :
Ultra early stage
Alteplase
Intravenous thrombolysis
NSE
Neural function
基金资助: 浙江省医药卫生科技计划项目(2016ZHB036)。
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